Perfusionist

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A perfusionist in front of a heart-lung machine (upper right) early in a coronary artery bypass surgery.

A perfusionist, also known as a clinical perfusionist, is a trained health professional who operates the heart-lung machine during cardiac surgery and other surgeries that require cardiopulmonary bypass.

The perfusionist is a highly trained member of the cardiothoracic surgical team which consists of cardiac surgeons, anesthesiologists, physician assistants, surgical technicians and nurses. The perfusionist's main responsibility is to support the physiological and metabolic needs of the cardiac surgical patient so that the cardiac surgeon may operate on a still, unbeating heart. This is accomplished through the utilization of the heart-lung machine, as well its associated components of an oxygenator, filters, reservoirs and tubing. The perfusionist is solely responsible for the circulatory and respiratory functions of the heart-lung machine. In addition, there is a spectrum of physiologic parameters that are constantly monitored by the perfusionist that ensures that the circulatory and respiratory needs of the patient are being met and allows the cardiac surgeon to focus on the actual surgical procedure and less on the immediate needs of the patient. Other responsibilities include autologous blood collection and processing, implementation and management of the intra-aortic balloon pump, adult and infant extracorporeal membrane oxygenation (ECMO) as well as monitoring of anticoagulation, electrolyte, acid-base balance and blood-gas composition. In many tertiary hospitals, perfusionists are also key personnel in placing and managing patients on ventricular assist devices as bridge to recovery or heart transplantation and supporting patients receiving lung or liver transplants. In certain hospitals, perfusionists can be involved in procurement of cardiothoracic donor organs for transplantation.

1 Training & Certification of Perfusionists
2 External links & General Information
3 Perfusion Service Providers

Training & Certification of Perfusionists

In the United States, a bachelor's degree, or sophomore level prerequisites with concentrations in biology, chemistry, anatomy and physiology are required to begin training in a perfusion program. As of 2006, there are 21 perfusion training programs in the United States. Training typically consists of two years of academic and clinical education. A two part exam is required to become a certified clinical perfusionist and use the designation C.C.P. The first portion of the two part process is the Perfusion Basic Science Exam, and the latter or second portion is the Clinical Applications in Perfusion Exam. Upon graduation from a perfusion program, the perfusionist is typically referred to as board eligible status, which is sufficient for employment in cardiac surgery with the understanding that advancing their status to a certified clinical perfusionist by passing both portions of the examination is required for long-term employment. Most hospitals or perfusion employers have stipulations on the duration board eligible status.

In order to qualify for this examination process, a perfusion student must have either graduated from or be enrolled in an accredited perfusion training program, as well as having participated in a minimum of 75 clinical procedures during the course of their training[1]. A perfusion student may qualify for the Perfusion Basic Science Exam before they actually matriculate from their respective training program. Once employment is provided, and the perfusionist has participated independently in a minimum of 50 clinical procedures, he or she can qualify for the Clinical Applications in Perfusion Exam[2]. Once the Clinical Applications in Perfusion Exam has been successfully passed, a perfusionist can use the designation C.C.P. In addition, there are recertification requirements for perfusionists in which proof of a minimum number of clinical procedures and attendance to scientific or educational meetings must be provided to a certifying body(i.e. American Board of Cardiovascular Perfusion or Canadian Society of Clinical Perfusion). These recertification requirements and subsequent verification process occurs every three years and is mandantory to maintain certified status and use the designation certified clinical perfusionist. As August of 2006, there were 3,328 certified perfusionists in the United States according to 2006 Annual Report of the American Board of Cardiovascular Perfusion.

In Canada, there are two training programs which are located in Toronto, Ontario and Montreal, Quebec. Applicants to the Michener Institute program in Toronto must have a bachelor's degree. The training program is 16 months to two years. The perfusion program of the Université de Montréal is a four year bachelor's degree in medical science of with 30 credits are specific to clinical perfusion.